Biomedical subjects

N Bogduk

Publications and source records attributed to N Bogduk.

131 records · Page 8Linked to original sources

PubMedDate not supplied

The lumbar mamillo--accessory ligament. Its anatomical and neurosurgical significance.

The anatomy of the lumbar mamillo-accessory ligament (MAL) was studied by gross dissection in six cadavers. The MAL bridges the mamillary and accessory processes of each lumbar vertebra and encloses the medial branch of the dorsal ramus in an osseofibrous tunnel. The tunnel maintains the proximal course of the medial branch in a constant relationship to bone. This constancy allows for accurate percutaneous techniques to stimulate, anesthetize or destroy the medial branch. The MAL morphologically appears to represent remnants of transversospinal elements in the lumbar region, and is ossified in over 10% of lower lumbar vertebrae. Ossification may interfere with some percutaneous denervation techniques. The MAL may be a site of entrapment of the medial branch and may be a source of low-back pain.

Back Pain↗

PubMedDate not supplied

The clinical anatomy of the cervical dorsal rami.

A detailed description of the anatomy of the cervical dorsal rami is provided on the basis of the past literature and independent studies on five cadavers. In particular, the anatomy of the upper cervical dorsal rami and the innervation of the cervical zygapophyseal joints are described. The clinical significance of the cervical dorsal rami is discussed in relation to headache, occipital neuralgia, and neck pain. The surgical anatomy of cervical facet denervation is discussed. The radiologic anatomy of the medial branches of the cervical dorsal rami is described, and target points suitable for diagnostic blocks or facet denervation are illustrated.

Cervical Vertebrae↗

PubMedDate not supplied

The menisci of the lumbar zygapophyseal joints. A review of their anatomy and clinical significance.

The literature describing menisci in the lumbar zygapophyseal joints is reviewed. The only true menisci in these joints are rudimentary fibrous invaginations of the dorsal and ventral capsule. So-called menisci at the superior and inferior poles of the joint are basically fat-filled synovial reflections, some of which contain dense fibrous tissue, which probably arises as a result of mechanical stress. The theory of meniscus entrapment is appraised, but is considered to have been an overstated cause of those forms of "acute locked back" that responds to manipulation.

Adipose Tissue↗

PubMedDate not supplied

Medial branch blocks are specific for the diagnosis of cervical zygapophyseal joint pain.

BACKGROUND AND OBJECTIVES: To determine the specificity of cervical medial branch blocks for the diagnosis of cervical zygapophyseal joint pain by ascertaining the disposition of the local anesthetic after injection of the medial branches of the cervical dorsal rami. METHODS: Sixteen consecutive patients with chronic neck pain from motor vehicle accidents underwent cervical medial branch blocks. A 22-gauge, 90-mm spinal needle was placed onto the target nerve under image-intensifier guidance. Immediately after each target nerve had been infiltrated with 0.5 ml of local anesthetic, 0.5 ml of contrast medium was injected to map the spread of injectate. Radiographs were recorded to document the pattern of spread. RESULTS: Twenty-five injections of local anesthetic and contrast medium were performed. Contrast medium dispersed in characteristic patterns at all vertebral levels and always incorporated at least 5 mm of the perceived course of the target nerve. There was never any spread to the ventral ramus, beyond the medial fibers of semispinalis capitis or to the adjacent medial branches. No other single structure was consistently within the field of the contrast. Eleven patients obtained complete or definite relief of their pain, which could only be attributed to anesthetization of the zygapophyseal joint innervated by the nerves blocked. CONCLUSIONS: Local anesthetic blocks of the cervical medial branches are a specific test for the diagnosis of cervical zygapophyseal joint pain. The local anesthetic always reaches the target nerve and does not affect any other diagnostically important structures.

Accidents, Traffic↗

PubMedDate not supplied

The anatomical basis for spinal pain syndromes.

Leading contenders for the anatomical basis of spinal pain are the discs, zygapophyseal joints and spinal muscles. There are no scientific data, however, that sustain the belief that muscles may be a source of chronic pain. On the other hand, controlled studies have shown how common discogenic pain and zygapophyseal joint pain are. Cervical zygapophyseal joint pain accounts for for more than 50% of chronic neck pain after whiplash. Collectively, lumbar zygapophyseal joint pain, internal disk disruption and sacroiliac joint pain account for nearly 70% of chronic low back pain.

Humans↗